H-HiP, Department of Orthopedic Surgery, Horsens Regional Hospital.
Department of Clinical Medicine, Health, Aarhus University.
Dan Med J. 2022 Jun 15;69(7):A09210714.
Bursitis at the greater trochanter has historically been identified as a major pain generator in patients with lateral hip pain (LHP). We believe that hip abductor tendon pathology (HATP) plays an important and overlooked role in LHP. The purpose of this study was to evaluate the presence of isolated trochanteric bursitis on MRI in patients with refractory LHP.
The MRIs of 120 patients with LHP (94% women, median age 54 years) performed at our orthopaedic outpatient clinic between 2017 and 2020 were evaluated by two raters for trochanter-related pathologies, including HATP and bursitis.
Two (2%) patients were registered with greater trochanteric bursitis with no relevant HATP, 30 (25%) patients had elements of inflammation (high-intensity signals) in the greater trochanteric bursa with relevant HATP. Five (4%) patients had relevant HATP with bursitis in the sub-gluteus minimus bursa with no bursitis in the greater trochanteric bursa. The remaining 83 (69%) patients had no sign of trochanter-related bursitis.
Isolated trochanteric bursitis as the cause of refractory LHP appears to be rare. We believe that the presence of HATP in LHP has been severely underestimated and a shift in focus towards treatment of these structures is necessary.
none.
According to current national legislation, no formal ethical approval was required for this study. The National Data Protection Agency approved the study (1-16-02-124-19).
大转子滑囊炎在既往被认为是导致髋关节外侧疼痛（LHP）的主要疼痛源。我们认为髋外展肌腱病变（HATP）在 LHP 中扮演着一个重要且被忽视的角色。本研究旨在评估在难治性 LHP 患者的 MRI 上是否存在孤立性转子滑囊炎。
对 2017 年至 2020 年在我们骨科门诊就诊的 120 例 LHP 患者（94%为女性，中位年龄 54 岁）的 MRI 进行评估，由两位评估者评估与转子相关的病变，包括 HATP 和滑囊炎。
2 例（2%）患者有大转子滑囊炎，但无相关的 HATP；30 例（25%）患者的大转子滑囊中存在炎症（高信号），且伴有相关的 HATP；5 例（4%）患者有相关的 HATP 伴臀小肌滑囊炎，而大转子滑囊中无滑囊炎；83 例（69%）患者无与转子相关的滑囊炎。
作为难治性 LHP 病因的孤立性转子滑囊炎似乎很少见。我们认为，LHP 中 HATP 的存在被严重低估了，需要将治疗重点转移到这些结构上。
无。
根据现行国家法规，本研究无需正式伦理批准。国家数据保护局批准了这项研究（1-16-02-124-19）。
